Breastfeeding: Encyclopedia II - Breastfeeding - History of breastfeeding

Breastfeeding - History of breastfeeding

In the early years of the human species, breastfeeding was as common as it was for other mammals feeding their young. There were no alternative foods for the infants, and the mother, along with other lactating females, would have no choice but to breastfeed the children. This process is still seen in many developing countries and is known as shared breastfeeding.

The Egyptian, Greek and Roman empires saw women only feeding their own children. However, breastfeeding began to be seen as something too common to be done by royalty, and wet nurses were employed to feed the children of the royal families. This was extended over the ages, particularly in western Europe, and saw women of noble birth (or who married into nobility) making use of wet nurses.

According to some Brahminical literature, breastfeeding in 2nd century India was commonly practised but not until the fifth day, allowing the colostrum to be discarded and the true breast milk to flow.

Breastfeeding - Developing alternatives

Alternatives first became popular in the late 15th century with many parents substituting cow or goat's milk for their own breast milk. This was particularly necessary for those families working the land whereby time could not easily be taken out to regularly breastfeed the child. Such trends soon faded when the problems associated with these milks started to show, and by the mid to late 16th century breastfeeding once again became the preferred feeding method for most families. The Italian Hieronymus Mercurialis wrote in 1583 that women generally finished breastfeeding an infant exclusively after the third month and entirely after around 13 months.

Dry nursing, the feeding of flour or cereal mixed with broth or water, became the next alternative in the 19th century but once again quickly faded. Around this time there became an obvious disparity in the feeding habits of those living in rural areas and those in urban areas. Most likely due to the availability of alternative foods, babies in urban areas were breastfed for a much shorter length of time, supplementing the feeds earlier than those in rural areas.

Though first developed by Henri Nestlé in the 1860s, infant formula received a huge boost during the post World War II "Baby Boom". The aggressive marketing campaigns when business and births decreased saw Nestlé and other such companies focus on non-industrialised countries, while government strategies in industrialised countries attempted to highlight the benefits of breastfeeding.

Breastfeeding - Breastfeeding in Japan

Traditionally, Japanese babies were born at home and breastfed with the help of breast massage. Weaning was often late, with breastfeeding in rare cases continuing until early adolescence. After World War II Western medicine was taken to Japan and the women began giving birth in hospitals, where the baby was usually taken to the nursery and fed formula. In 1974 a new breastfeeding promotion by the government helped to boost the awareness of its benefits and the uptake has seen a sharp increase. Japan became the first developed country to have a Baby-friendly hospital (and has since gone on to have another 24 such facilities).

Breastfeeding - Breastfeeding in Canada

A 1994 Canadian government health survey found that 73% of Canadian mothers initiated breastfeeding, up from 38% in 1963.[45] Western Canadians are more likely to breastfeed; just 53% of Atlantic province mothers breastfeed, compared to 87% in British Columbia. More than 90% of women surveyed said they breastfeed because it provides more benefits for the baby than does formula. Of women who did not breastfeed, 40% said formula feeding was easier (the most prevalent answer). Women who were older, more educated, had higher income, and were married were the most likely to breastfeed. Immigrant women were also more likely to breastfeed. About 40% of mothers who breastfed do so for less than three months. Women were most likely to discontinue breastfeeding if they perceived themselves to have insufficient milk. However, among women who breastfed for more than three months, returning to work or a previous decision to stop at that time were the top reasons.

A 2003 La Leche League International study found that 72% of Canadian mothers initiate breastfeeding and that 31% continue to do so past four to five months.[46]

A 1996 article in the Canadian Journal of Public Health found that, in Vancouver, 82.9% of mothers initiated breastfeeding, but that this differed by Caucasian (91.6%) and non-Caucasian (56.8%) women.[47] The article reported that just 18.2% of mothers breastfeed at nine months, and that breastfeeding practices were significantly associated with the mothers' marital status, education and family income.

Breastfeeding - Breastfeeding in Cuba

Since 1940, Cuba's constitution has contained a provision officially recognising and supporting breastfeeding. Article 68 of the 1975 constitution reads, in part:

Breastfeeding - Publicity promotion and law

In response to public pressure, the health departments of various governments have recognised the importance of encouraging women to breastfeed. The required provision of baby changing facilities was a large step towards making places more accessible for parents and in many countries there are now laws in place to protect the rights of a breastfeeding mother when feeding her child in public.

The World Health Organization (WHO), along with grassroots non-governmental organisations like the International Baby Food Action Network (IBFAN) have played a large role in encouraging these governmental departments to promote breastfeeding. Under this advice they have developed national breastfeeding strategies, including the promotion of its benefits and attempts to encourage mothers, particularly those under the age of 25, to choose to feed their child with breast milk.

Government campaigns and strategies around the world include:

• National Breastfeeding Week in the UK
• The Department of Health and Ageing Breastfeeding Strategy in Australia
• The National Women's Health Information Center in the U.S.
• La Leche League International, a volunteer mother-to-mother international group.
• World Breastfeeding Week

However, there has been a long, ongoing struggle between corporations promoting artificial substitutes and grassroots organisations and WHO defending breastfeeding. The International Code of Marketing of Breast-milk Substitutes was developed in 1981 by WHO, but violations have been reported by organisations, including those networked in IBFAN. In particular, Nestle took three years before it initially implemented the code, and in the late 1990s and early 2000s was again found in violation. Nestle had previously faced a boycott, beginning in the US but soon spreading through the rest of the world, for its third world marketing practices (see Nestle boycott).

In many countries, particularly those with a generally poor level of health, malnutrition is the majority cause of death in children under 5, with 60% of all those cases being within the first year of life [48]. International organisations such as Plan International and La Leche League have helped to promote breastfeeding around the world, educating new mothers and helping the governments to develop strategies to increase the number of women exclusively breastfeeding.

Traditional beliefs in many developing countries give different advice to women raising their newborn child. In Ghana babies are still frequently fed with tea alongside breastfeeding [49]. This reduces the benefits of exclusive breastfeeding and the drink can inhibit the absorption of iron, important in the prevention of anaemia.

When in public with a breastfed baby it is often difficult to avoid the need to feed the infant. Therefore legal and social rules regarding indecent exposure and dress code, as well as inhibitions of the woman, tend to be relaxed for this situation. There are numerous laws around the world that have made public breastfeeding legal and disallow companies from prohibiting it in the workplace. Yet, the public reaction at the sight of breastfeeding can make the situation uncomfortable for those involved.

In the U.S. an appropriations bill (H.R.2490) with a breastfeeding amendment (H.AMDT.295 to H.R.2490) was signed into law on September 29, 1999 affirming the right of a woman to breastfeed her child anywhere on federal property. However, not all state laws have affirmed the same right in their respective public places. Recent attempts to codify a child's right to nurse found success in Ohio, but failed in West Virginia and some other states. By June 2005, 35 states had enacted legislation to protect breastfeeding mothers and their children. Laws protecting the right to nurse aim to change attitudes and promote increased incidence and duration of breastfeeding. Nowhere is breastfeeding in public illegal.

A survey reported by the UK Department of Health stated that most people (84%) find breastfeeding in public acceptable as long as it is done discreetly [50]. Contrastingly, 67% of mothers are worried about general opinion being against public breastfeeding. To combat these fears in Scotland, a bill [51] (pdf) safeguarding the freedom of women to breastfeed in public has been passed [52] in the Scottish Parliament [53]. The legislation sets up a fine of up to £2500 for preventing breastfeeding in legally permitted places.

In Canada, the Canadian Charter of Rights and Freedoms affords some protection under sex equality. Although Canadian human rights protection does not explicitly include breastfeeding, a 1989 Supreme Court of Canada decision (Brooks v. Canadian Safeway Ltd.) set the precedent for pregnancy as a condition unique to women and that thus discrimination on the basis of pregnancy is a form of sex discrimination. Canadian legal precedent also allows women the right to bare their breasts, just as men may. In British Columbia, the British Columbia Human Rights Commission Policy and Procedures Manual protects the rights of female workers who wish to breastfeed.

Some mothers choose to pump or express milk by hand so that they can carry a small bottle of milk with them if they plan to be out at mealtimes.

Breastfeeding - Recent global uptake

The following table shows the uptake of exclusive breastfeeding. Sources: WHO Global Data Bank on Breastfeeding and UNICEF Global Database Breastfeeding Indicators

Adapted from the Wikipedia article "History of breastfeeding", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki